同期经尿道等离子体双极电切术联合钬激光碎石术治疗尿道狭窄合并膀胱结石46例疗效分析

目的探讨经尿道等离子体双极电切术（PKRP）联合钬激光碎石术对尿道狭窄合并膀胱结石患者进行治疗的临床效果。方法随机将我院91例尿道狭窄合并膀胱结石患者进行分组,对照组给予输尿管镜联合钬激光行尿道狭窄切开术,观察组给予PKRP联合钬激光碎石术,观察两组手术效果。结果观察组手术时间和术中出血量明显低于对照组,P〈0.01;观察组平均尿流率（18.62±2.83）mL/s明显高于对照组（15.58±2.85）mL/s,P〈0.01;观察组平均剩余尿量（5.02±1.19）mL明显低于对照组（6.13±1.21）mL,P〈0.01;观察组术后并发症发生率6.52%低于对照组11.11%（P〉0.05）。结论采用等离子体双击电切术联合钬激光碎石术对尿道狭窄合并膀胱结石患者进行治疗,能够有效的改善患者的输尿管功能,提高尿流率和降低残余尿量,在促进患者早期康复方面具有非常重要的意义。

Efficacy analysis of transurethral plasma bipolar electrocision combined with holmium laser lithotripsy in treatment of 46 patients with urethrostenosis complicated by cystolith

Objective To investigate the clinical effects of transurethral plasma bipolar electrocision combined with holmium laser lithotripsy in the treatment of patients with urethrostenosis complicated by cystolith. Methods Ninety-one patients with urethrostenosis complicated by cystolith of our hospital were randomly divided into two groups. The control group was given urethrostenosis dissection using ureteroscope combined with holmium laser and the observation group was given transurethral plasma bipolar electrocision combined with holmium laser lithotripsy. The surgical effects of the two groups were observed. Results The observation group had significantly lower surgical time and intraoperative blood loss than the control group（P〈0.01）; The observation group had significantly higher average urine flow rate（18.62±2.83） mL/s than the control group（15.58±2.85） mL/s（P〈0.01）; The incidence of postoperative complications（6.52%） of the observation group was not significantly different from that（11.11%） of the control group（P〈0.05）. Conclusion In the treatment of patients with urethrostenosis complicated by cystolith, the application of transurethral plasma bipolar electrocision combined with holmium laser lithotripsy can effectively improve the patients＇ ureteral function, increase the urine flow rate and reduce the residual urine volume, and is of highly important significance to promoting early rehabilitation of patients.